P084 What does paediatric rheumatology care look like? National insights from the Getting It Right First Time programme

Abstract Background/Aims In England, the 2025 paediatricrheumatology Getting It Right First Time (GIRFT) report identified that carewas delivered by more than the 16 commissioned paediatric rheumatology providers.Understanding paediatric rheumatology care pathways is an important first steptowards meaningful data-driven improvement, designed to support equitableaccess to care for children and young people living with rheumatic conditions. Methods We extracted data fromHospital Episode Statistics (HES) for England for all outpatient encounterscoded to rheumatology or paediatric rheumatology for people ≤17 years of ageacross two financial years (2023/24 and 2024/25). Data pertaining to age, referral source, coded diagnoses, appointment type, and clerical outcomes wereanalysed descriptively. Results A total of 173,984 encountersinvolving 41,143 unique patients were recorded. Most encounters (72.5%) werecoded to commissioned providers, with 27.5% taking place elsewhere. The medianage at appointment was 13 years (interquartile range IQR 9-15 years). Newreferrals comprised 24% of encounters, with fewer than half (46%) referred fromgeneral practice, as opposed to being referred by other hospital specialties.Approximately 70% of encounters were attended, 20% were subject to patient orhospital cancellation and around 5% coded as patients not being brought to theappointment. Approximately 89% of encounters were conducted face to face, with11% being virtual. Approximately 25% of patients were discharged at their firstappointment. Around 80% of encounters lacked diagnostic coding. Conclusion Understanding the existingprovision of paediatric rheumatology care is a key precursor to coherent andeffective improvement, including development of accessible and meaningful carepathways, designed to support timely access to the best possible care. HES datademonstrate that over half of new referrals are made by secondary careproviders; advice and guidance opportunities therefore need to be accessibleacross both primary and secondary care. Since almost one-third of paediatric rheumatologycare is delivered by non-commissioned providers, commissioned providers need towork with local colleagues to ensure equitable cross-regional access tospeciality paediatric rheumatology multidisciplinary care. Recognising the highproportion of adolescent patients, teams need support to deliver accessible anddevelopmentally appropriate care. The paucity of diagnostic coding datarendered descriptions of case mix unfeasible and forms the subject of futurework. Disclosure R.D. Sandler: None. W.K. Gray: None. G. Cleary: None. L. Martin: None. L.J. Kay: None. P.C. Lanyon: None. F. McErlane: None.